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Abstract: Acute tympanitis can manifest as acute inflammation of the tympanic membrane and the skin of the external auditory canal adjacent to the tympanic membrane, with the onset of herpetic tympanitis, for example, occurring mostly in children and people under 30 years of age. The patient was found to have herpetic tympanitis, a type of acute tympanitis, and the pain symptoms were initially relieved after standard drug treatment.
Basic information】Male, 25 years old
Disease Type】Herpetiform tympanitis
Hospital】Northern War Zone General Hospital
Date of consultation】November 2021
Treatment plan】Medication (ibuprofen + acyclovir + phenol glycerin) + physiotherapy (baking electricity treatment)
Treatment period】1 week of outpatient treatment
Effectiveness of treatment】Ear pain symptoms improved
I. Initial consultation
The patient, male, 25 years old, reported his medical history: he had a history of upper respiratory tract infection 1 week before the onset of otalgia, and developed otalgia 1 day ago. After briefly communicating with the patient about his condition, we conducted a physical examination and found that the endoscopy showed bloody secretions in the external ear canal, and there were purple blood blisters of various sizes on the surface of the eardrum and in the deep part of the external ear canal, and the eardrum was obviously congested.
II. Treatment history
To further clarify the diagnosis, the patient was advised to undergo a CT examination of the middle ear, which showed that the middle ear mastoid was accompanied by inflammation and maxillary sinusitis (see the figure below), so the patient was diagnosed with herpetic tympanitis. An appropriate treatment plan was then chosen for the patient. Because the patient was in severe pain, ibuprofen was considered for pain relief; because herpes is mostly a viral infection, the patient was given acyclovir for antiviral treatment; the patient was also instructed to use phenol glycerin drops in the ear canal, which can assist in relieving the symptoms of ear pain. During the treatment period, pay attention to the cleanliness of the external ear canal, and you can go to the rehabilitation physiotherapy department for baking electricity to promote the absorption of inflammation in the external ear canal.
(Middle ear CT)
III. Treatment effect
Acyclovir helps antiviral, and ibuprofen and phenol glycerin help relieve the severe pain symptoms appearing in the ear. After 1 week of standardized medication and baked electricity physiotherapy treatment, the patient’s ear pain symptoms improved significantly and he could resume normal work and life. After 1 week of treatment, the otoscope was rechecked and the results showed that the mucous membrane of the ear canal was not significantly congested, the blood blisters on the surface of the tympanic membrane had crusted over, and the congestion of the tympanic membrane was also reduced.
IV. Precautions
The patient’s condition has improved significantly, which is gratifying. At the early stage of recovery, the same attention should be paid to the care at home. Patients should be instructed to pay attention to keeping the external ear canal clean and hygienic; until the condition is completely improved, attention should be paid to protecting the external ear canal from unclean water or other substances. During the recovery process, the ear may become slightly itchy, so avoid digging your ear to avoid re-infection. In your life, you should eat a reasonable diet, ensure balanced nutrition, participate in appropriate exercise, avoid staying up late, and enhance your physical fitness.
V. Personal insight
Herpetic tympanitis is a kind of acute tympanitis, which is a common disease in ENT clinics and often attracts attention because of the obvious pain. Patients are advised to exercise more and improve their resistance.